Module 5

How did the readings influence your perception of your own clinical decision-making?

To summarize my graduate school experience thus far: The more I learn, the more I realize I don't know. This Module has driven that realization home yet again. When I think about the sheer volume of medical information that I will need to process for each and every patient encounter in my future clinical practice, I am overwhelmed. Production of new information and evidence- largely facilitated by technological advances- has accelerated to the point that much of what I learn in my classes at the U of U may very well be already outdated by the time I begin practicing two years from now. When I think of the challenge of synthesizing this avalanche of data into evidence-based, unbiased, patient-centered care... well, it's daunting to say the least!

Then I take a breath and remind myself that these very same technological advances are also providing us with more and more tools for managing this information. A fascinating recent article in Science (http://www.sciencemag.org/content/early/2011/07/13/science.1207745) describes how the Internet is serving as external "transactive memory," literally changing the way we remember facts. Instead of memorizing the data itself, we remember how to access the data via a search engine or electronic file. Advances in clinical decision support systems, mobile health applications for diagnostics and patient monitoring, and the new frontier of personalized genomic medicine are breathtaking.  Instead of being mistrustful and resistant to technology as an aid for clinical decisions, I believe we must recognize with humility that developing these tools is the only way to truly provide evidence-based care.